The course of cravings in women with co-morbid disorder undergoing cognitive behavioral treatments

The purpose of this study was to examine the course of cravings in women undergoing cognitive behavioral therapy (CBT) and who meet criteria for both substance use disorder (SUD) and Post Traumatic Stress Disorder (PTSD). In addition, this study examined the relationship between cravings, trauma and substance use. The women studied engaged in one of two possible treatment groups. Women with histories of substance abuse and trauma were randomly chosen for either the Relapse Prevention Treatment (RPT) or Seeking Safety (SS) treatment.; This study was a secondary analysis of Hien et al.'s completed clinical trial data to explore in greater detail the weekly report of cravings, its relationship to trauma and the impact of both phenomena with substance use among women undergoing both SS and RPT treatments. In addition, this study sought to examine how levels of dissociation in subjects may mediate subsequent substance abuse patterns.; In this study 42 female participants were randomly chosen for either the RPT or SS treatment group. Trauma symptomatology was assessed at three timepoints over the course of treatment. Cravings and substance use were also assessed on a weekly basis for the 12 weeks of treatment. Trauma was assessed using the Impact of Events Scale (IES) at baseline, mid-phase and termination. In addition, the Dissociative Experiences Scale (DES) was used to identify subjects as high or low in dissociation. Participants were asked on a weekly basis about their cravings, which were coded on a self-report craving scale. Participants were also asked about their substance use over the past week using the Substance Use Inventory (SUI) and weekly urine toxicology screens were administered.; Results were varied, but overall no differences were found between the SS and RPT treatment groups via weekly measures of cravings and PTSD symptoms. Instead, significant differences and trends were found among variables within both treatment groups. For example, cravings were strongly associated with substance use. In addition, low intrusion scores at baseline had a strong relationship with reported substance use at the pre-midphase of treatment. Low DES scores were strongly associated with substance use. Trends were found between low DES scores and cravings.